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Dana (C4-5, 31 years post, 51, KC)
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--- Begin Message -------- Original Message ----- > <http://www.stltoday.com/stltoday/news/stories.nsf/editorialcommentary/story > /A89F32CB8BAD093F8625706E003235D6?OpenDocument>http://www.stltoday.com/stlto > day/news/stories.nsf/editorialcommentary/story/A89F32CB8BAD093F8625706E00323 > 5D6?<http://www.stltoday.com/stltoday/news/stories.nsf/editorialcommentary/s > tory/A89F32CB8BAD093F8625706E003235D6?OpenDocument>OpenDocument > MISSOURI'S MEDICAID SHAME: Feeding tubes optional > > 08/31/2005 > > FEEDING TUBES AND nutritional formula aren't optional for thousands of > Missourians with severe brain damage or disabilities. Without them, people > can't eat. > > But beginning tomorrow, Missouri Medicaid no longer will pay for them. Nor > will it pay for breathing machines for people with respiratory failure; for > canes, crutches and walkers; for cushions to prevent life-threatening bed > sores; or for wheelchair batteries. > > These things are technically known as "optional" > equipment and services under current Medicaid rules. Gov. Matt Blunt and > Republican lawmakers cut them during the past legislative session, denying > equipment to about 340,000 adults covered by Medicaid. > > But the governor's office insists things aren't as bad as they sound. The > cuts "will not impact access to life-sustaining nutrition," Jessica > Robinson, the governor's spokeswoman, told Virginia Young of the > Post-Dispatch. "Gov. Blunt upholds the values that reinforce the right to > life." > Mr. Blunt's office says that people who need feeding tubes still can apply > for "exceptions." > There are just a couple of catches. > > For one, the vast majority of Medicaid patients have no clue about > "exceptions". That's because there was no mention of them in the letters the > state began sending Medicaid patients in May informing them about the cuts. > For another thing, patients can't file exceptions on their own; they have to > get letters from their doctors asking for an exception. > > Patients who are losing feeding tubes and other equipment have been told > they can file appeals. > But the results to date are less than encouraging. > As of last Wednesday, 1,048 people had filed appealed. Of the 427 appeals > hearings held, the patient lost in 396 of them. > > Peggy Bishop of Theodosia, Mo. appealed the loss of her Medicaid coverage. > Mrs. Bishop depends on a battery of medical equipment, including a nebulizer > that shoots medicine directly into her lungs. > > Mrs. Bishop submitted a half-dozen letters from doctors attesting to her > need for care. The letters were "irrelevant," an administrative hearing > officer decided. > > Jan Everett, whose 21-year-old son, Joey, depends on a feeding tube to get > nutritional formula, said her request for an exception was denied. An appeal > still is pending. The feeding tube is the only way that Joey can eat. He > can't swallow because of a traumatic brain injury he suffered in an auto > accident four years ago. > > The Missouri Medicaid Reform Commission - co-chaired by Sen. Charles W. > Shields, R-St. > Joseph, and state Rep. Jodi Stefanick, R-Ballwin - is scheduled to start two > days of hearings in St. > Louis today. Ms. Stefanick, an architect of the Medicaid cuts, recently was > named the governor's senior health care advisor. > > At past meetings, Ms. Stefanick has given a cold reception to citizens who > wanted to testify about the impact of this year's cuts. She has asked, > instead, that testimony focus on ways of making Medicaid cheaper and more > efficient. > > By making coverage for feeding tubes and breathing machines optional, > Missouri lawmakers are doing swell on the cost-cutting side. The trick now > is to square that with "values that reinforce the right to life." > > - 30 -NATIONAL ADAPT MAILING LIST - Adapt MiCASA List http://www.adapt.org
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